374604148-2-6-2025-08-AS-SJAB-DEXP9C-20250320110655

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604148
Report Date: 02/06/2025
Date Signed: 02/06/2025 03:46:59 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/29/2025 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20250129162352

FACILITY NAME:	ABIGAIL'S HOMES II		FACILITY NUMBER:	374604148
ADMINISTRATOR:	GONZALEZ, BRENDA ABIGAIL		FACILITY TYPE:	735
ADDRESS:	8738 VALENCIA ST		TELEPHONE:	(619) 315-7407
CITY:	SPRING VALLEY	STATE: CA	ZIP CODE:	91977
CAPACITY:	4	CENSUS: 2	DATE:	02/06/2025
		UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Daniel Moreno, Staff		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

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Facility staff do not provide sufficient meals to clients

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced complaint visit to initiate an investigation on the above-mentioned allegation. LPA met with Daniel Moreno, Staff and discussed the basic elements of the complaint.

During investigation, LPAs collected pertinent client records, made observations, and conducted interviews. On January 29, 2025, Community Care Licensing (CCL) received a complaint alleging staff did not provide sufficient meals to clients. Interviews revealed that on today's date Client 1 (C1) took a frozen burrito and a jello cup to program. Interviews revealed C1 brought leftovers and ate that for breakfast (french fries and a burger). Interviews revealed that staff do not give clients breakfast unless if they ask for it. Interviews also revealed that they usually give a granola bar and corn dogs or pizza rolls. LPA observation revealed there was frozen meat, pizza rolls, hot pockets, french fries, bolonga, frozen fruit and chicken in the freezer. LPA observation also revealed that in the refrigerator theren was tortillas, eggs, 2 potatoes and some onions.

(Continued form 9099)

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20250129162352

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ABIGAIL'S HOMES II	FACILITY NUMBER: 374604148
	VISIT DATE: 02/06/2025

NARRATIVE

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LPA observations also revealed that on 02/03/2025 C1 had a Jello cup, Kool aid jammers juice and a burrito rolled in a sandwich bag (Picture of meal was provided to LPA). On today's date LPA Holmes was also provided a picture of C1s lunch. Interviews revealed the staff go shopping off of a list and the staff do not ask the clients what they want and or like to eat. Interviews revealed they buy the same food every month. Interviews revealed that if a client knows how to fend for themselves that the staff will have them put their lunches/snacks together without assistance most of the time. Interviews revealed the facility buys cheaper, unhealthy foods instead of the nutritious meals. LPA observation also showed that for dinner on Today's date beef and frozen vegetables were being made. Staff stated they were going to make potatoes with the meal as well.

Based on the evidence obtained, interviews and outside source interviews, the above-mentioned allegation is substantiated. The allegation is valid because the preponderance of the evidence standard has been met. California code of Regulations, Title 22, Division 6 & Chapter 1 is being cited on the attached LIC 9099D.

An exit interview was conducted with Daniel Moreno, Staff and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visit.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20250129162352

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ABIGAIL'S HOMES II	FACILITY NUMBER: 374604148
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/06/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/14/2025 Section Cited CCR 80076(a)(1)	1 2 3 4 5 6 7	Food Service (a) in all facilities providing meals to clients (1)all food shall be...of the quality and in the quantity necessary to meet the needs of the clients. Each meal shall meet at least 1/3 of the servings recommended in the USDA food plan.This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee will create a daily or weekly food menu option to meet the needs of C1's diet and provide training to caregivers on assisting C1 with food choices. Licensee will provide proof of menu and training to LPA by POC due date of 02/14/2025.
	8 9 10 11 12 13 14	Based on interviews and observations the licensee did not provide meals in the quality or quantity necessary to meet the needs of the clients in 1 of 2 persons in care (C1) which posed a potential Health risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025

LIC9099 (FAS) - (06/04)

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